Abstract: A 56-year old male patient was reported to have been admitted to the hospital due to ‘‘fatigue accompanied by yellow staining of the skin and sclera for one week’’. The patient had a history of heavy alcohol consumption for over 30 years, averaging approximately 150 mL of 40% vol alcohol daily. Upon admission, liver function tests revealed a total bilirubin level of 292.6 μmol/L, alanine aminotransferase of 716.0 U/L, and a prothrombin time of 14.6 seconds. Imaging examinations indicated liver cirrhosis, splenomegaly, and ascites. After admission, the patient received comprehensive treatment including hepatoprotective and cholagogic therapy for over one week. However, bilirubin levels continued to rise progressively. Gastroscopy revealed multiple gastric ulcers, posing a risk of gastrointestinal bleeding. Under close monitoring, a short course of low-dose methylprednisolone therapy (starting at 40 mg/day for a total of 12 days) was initiated. On day 7 of corticosteroid therapy, the Lille Score was 0.142, indicating a complete response, and liver function gradually improved. During treatment, the patient developed progressive thrombocytopenia (reaching a nadir of 35.0×10⁹/L), which resolved after treatment with Leucogen and recombinant human thrombopoietin. Follow-up after discharge showed normal liver function and blood routine tests. This case suggests that a short course of low-dose glucocorticoid therapy is a safe and feasible option for patients with alcohol-related liver failure complicated by a risk of gastrointestinal bleeding, provided that a full risk-benefit assessment and close monitoring of clinical indicators are performed.